Institution
Makerere University
Education•Kampala, Uganda•
About: Makerere University is a education organization based out in Kampala, Uganda. It is known for research contribution in the topics: Population & Acquired immunodeficiency syndrome (AIDS). The organization has 7220 authors who have published 12405 publications receiving 366520 citations. The organization is also known as: Makerere University Kampala & MUK.
Papers published on a yearly basis
Papers
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TL;DR: Enterocytozoon bieneusi is widespread among children 3-36 months of age in Uganda, and that in a cross-sectional study, there was no clear association of E. bienesi with poor nutrition or diarrhea.
Abstract: The prevalence of Enterocytozoon bieneusi in the general population is unknown. Using genetic tools, we investigated its prevalence and contribution to diarrhea and malnutrition in hospitalized children in Uganda. A cross-sectional, case-control study involving diarrheic children who were matched for age and sex (3:1) with control children. Measurements included anthropometry and clinical assessment. A total of 17.4% of 1,779 children with diarrhea were infected with E. bieneusi compared with 16.8% of 667 control children (CHI2 = 0.137, P = 0.712). Prevalence was highest during the rainy seasons. There was no significant relationship between infection with E. bieneusi and stunting, being underweight, wasting, or acute diarrhea. However, children who were E. bieneusi-positive by a polymerase chain reaction (PCR) had diarrhea for a longer period (15.15 versus 9.67 days; F = 12.02; P = 0.001) compared with children who were either uninfected or were E. bieneusi-positive by a nested PCR. We conclude that E. bieneusi is widespread among children 3-36 months of age in Uganda, and that in a cross-sectional study, there was no clear association of E. bieneusi with poor nutrition or diarrhea. Since E. bieneusi is closely linked with persistent diarrhea and wasting in adults who are positive for human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), the outcome of follow-up studies involving children who are HIV/AIDS-positive and severely malnourished children may be entirely different and warrants further study.
101 citations
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TL;DR: Using the risk of symptomatic malaria once parasitemic as an outcome may improve detection of associations between immune responses and protection from disease.
Abstract: A major impediment to malaria vaccine development has been a lack of understanding of which immunologic responses are important in protection. Naturally acquired antibodies to Plasmodium falciparum are known to play a key role in immunity against malaria [1, 2]. However, it is still unclear which antibody responses are important in protection from disease despite a number of immunoepidemiology studies that have attempted to answer this question.
Multiple studies have measured antibody responses to P. falciparum in individuals living in areas where malaria is endemic and prospectively assessed associations between antibody responses and the subsequent risk of malaria. However, associations between antibodies to parasite antigens and the risk of malaria have been inconsistent [3]. A limitation of this study design has been that it does not take into account variation in P. falciparum transmission intensity [4], which has consistently been observed to vary within a small geographical area [5–14]. Individuals living in microenvironments with greater transmission intensity may have a greater breadth and magnitude of antibody responses, because of greater exposure to plasmodial antigens [12, 13], but clinical benefits of these responses may be obscured by increased incidence of disease resulting from increased exposure. A proposed solution is to limit analysis to individuals with documented exposure [4], but this does not account for varied degrees of positive exposure. On the other hand, some measured antibodies may not offer protection, but rather are only surrogates of effective immune responses. These antibody responses may be higher in persons more exposed who therefore possess higher immunity, but play no causal role in protection. Thus, failure to take into account correlations between responses may lead to an overstatement of the causal effect of individual responses.
To address inconsistent associations between antibody responses to P. falciparum and protection against malaria, we measured responses to 5 P. falciparum antigens in a cohort of children in Kampala, Uganda, where heterogeneity in malaria incidence has been well defined [8]. We performed analyses with use of a standard outcome of protection (time to first malaria episode) and an outcome focused on blood-stage immunity, defined as protection from symptoms once parasitemic. By assessing parasitemia and malaria monthly, we were able to account for variation in P. falciparum exposure in our analysis and assess the impact of this variation on associations between antibodies and protection from malaria.
101 citations
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TL;DR: Results indicate that continuous control activities can be cost-effective in reducing tsetse populations, especially where the creation of fly-free zones is challenging and reinvasion pressure high.
101 citations
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TL;DR: The uptake of family planning among HIV-infected individuals is fairly high, however, there are a large number of unplanned pregnancies, which highlight the need for strengthening ofFamily planning services for HIV- Infected people.
Abstract: Prevention of unplanned pregnancies among HIV-infected individuals is critical to the prevention of mother to child HIV transmission (PMTCT), but its potential has not been fully utilized by PMTCT programmes. The uptake of family planning methods among women in Uganda is low, with current use of family planning methods estimated at 24%, but available data has not been disaggregated by HIV status. The aim of this study was to assess the utilization of family planning and unintended pregnancies among HIV-infected people in Uganda.
101 citations
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TL;DR: The novel observation of this study is that the CD4+ percentages in both HIV-positive and HIV-negative children without oedema were lower that those in children with Oedema, which appears to imply that the development of oedematous malnutrition requires a certain degree of immunocompetence.
Abstract: Background: The aim of this study was to describe the clinical features, haematological findings and CD4 + and CD8 + cell counts of severely malnourished children in relation to human immunodeficiency virus (HIV) infection. Methods: The study was conducted in the paediatric wards of Mulago hospital, which is Uganda's national referral and teaching hospital. We studied 315 severely malnourished children (presence of oedema and/ or weight-for-height: z-score 18 months of age, and RNA PCR was performed for those ≤18 months. Complete blood count, including differential counts, was determined using a Beckman Coulter counter. Results: Among the 315 children, 119 (38%) were female; the median age of these children was 17 months (Interquartile range 12–24 months), and no difference was observed in the HIV status with regard to gender or age. The children showed a high prevalence of infections: pneumonia (68%), diarrhoea (38%), urinary tract infection (26%) and bacteraemia (18%), with no significant difference with regard to the HIV status (HIV-positive versus HIV-negative children). However, the HIV-positive children were more likely to have persistent diarrhoea than the HIV-uninfected severely malnourished children (odds ratio (OR) 2.0, 95% confidence interval (CI) 1.2–3.6). When compared with the HIV-negative children, the HIV-positive children showed a significantly lower median white blood cell count (10700 versus 8700) and lymphocyte count (4033 versus 2687). The CD4 + cell percentages were more likely to be lower in children with nonoedematous malnutrition than in those with oedematous malnutrition even after controlling for the HIV infection. The novel observation of this study is that the CD4 + percentages in both HIV-positive and HIV-negative children without oedema were lower that those in children with oedema. These observations appear to imply that the development of oedema requires a certain degree of immunocompetence, which is an interesting clue to the pathophysiology of oedema in severe malnutrition.
101 citations
Authors
Showing all 7286 results
Name | H-index | Papers | Citations |
---|---|---|---|
Pete Smith | 156 | 2464 | 138819 |
Joy E Lawn | 108 | 330 | 55168 |
Philip J. Rosenthal | 104 | 824 | 39175 |
William M. Lee | 101 | 464 | 46052 |
David R. Bangsberg | 97 | 463 | 39251 |
Daniel O. Stram | 95 | 445 | 35983 |
Richard W. Wrangham | 93 | 288 | 29564 |
Colin A. Chapman | 92 | 491 | 28217 |
Ronald H. Gray | 92 | 529 | 34982 |
Donald Maxwell Parkin | 87 | 259 | 71469 |
Larry B. Goldstein | 85 | 434 | 36840 |
Paul Gepts | 78 | 263 | 19745 |
Maria J. Wawer | 77 | 357 | 27375 |
Robert M. Grant | 76 | 437 | 26835 |
Jerrold J. Ellner | 76 | 347 | 17893 |